Running Out of Time: Physician Management of Behavioral Health Concerns in Rural Pediatric Primary Care

Cooper, Stephanie; Valleley, Rachel J.; Polaha, Jodi; Begeny, John C.; Evans, Joyce J.

doi:10.1542/peds.2005-2612

Cited by 128 publications

(101 citation statements)

References 22 publications

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“…Rural settings present particular challenges to accessing behavioral health services because of shortages of providers. While primary care providers in rural settings often attempt to address their patients' behavioral health needs, limitations in time, expertise, and reimbursement for such services (18,19) are barriers to addressing the often complex behavioral health and family dynamic needs of youth with poorly controlled diabetes. Accessibility limitations in rural and underserved communities often require families to travel considerable distances to receive services or forgo mental health services altogether.…”

mentioning

confidence: 99%

Seeing Is Believing: Using Skype to Improve Diabetes Outcomes in Youth

2015

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OBJECTIVEThe objective of this study was to compare the relative effectiveness of two modes of delivering Behavioral Family Systems Therapy for Diabetes (BFST-D) to improve adherence and glycemic control among adolescents with type 1 diabetes with suboptimal glycemic control (HbA 1c ‡9.0% [ ‡74.9 mmol/mol]): face to face in clinic (Clinic) and Internet videoconferencing (Skype) conditions. RESEARCH DESIGN AND METHODSAdolescents aged 12 to 18 years and at least one adult caregiver were randomized to receive BFST-D via the Clinic or Skype condition. Participants completed up to 10 therapy sessions within a 12-week period. Changes in youth-and parentreported adherence and glycemic control were compared before and after the intervention and at follow-up assessment. RESULTSUsing an intent-to-treat analytic approach, no significant between-group differences were identified between the before, after, and follow-up assessments. Groups were collapsed to examine the overall effects of BFST-D on adherence and glycemic control. Results identified that statistically significant improvements in adherence and glycemic control occurred from before to after the intervention; improvements were maintained at 3-month follow-up. CONCLUSIONSDelivery of BFST-D via Internet-based videoconferencing is viable for addressing nonadherence and suboptimal glycemic control in adolescents with type 1 diabetes, potentially reducing important barriers to care for youth and families.

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mentioning

confidence: 99%

Seeing Is Believing: Using Skype to Improve Diabetes Outcomes in Youth

2015

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“…[10][11][12][13][14][15][16][17] Las causas más frecuentes que motivaron la hospitalización fueron los problemas de salud relacionados con la violencia, el SMI, la SAS y los comportamientos suicidas, también en concordancia con otros estudios. [3][4][5][8][9][10]14 Estos problemas de salud mostraron un comportamiento diferenciado por edad y género, y se encontró que, en los niños más pequeños (lactantes), la internación fue motivada por SMI y, en las niñas en edad escolar y mujeres adolescentes, por SAS y comportamientos suicidas, lo que coincide con lo referido en la bibliografía.…”

Section: Discussionunclassified

Demanda de hospitalización por causas psicosociales en un hospital pediátrico

Bella

Borgiattino

2016

Arch Argent Pediat

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“…Pediatric primary care (PPC) is often the first stop for families with behavioral, emotional, or developmental concerns for their children with 40-70% percent of people seeking behavioral health services exclusively in primary care (Kessler & Stafford, 2008). However, pediatric primary care providers (PCPs) face significant barriers to providing behavioral care including insufficient time, inadequate training, and poor reimbursement (Cooper, Valleley, Polaha, Begeny, & Evans, 2006;Nasir, Watanabe-Galloway, & DiRenzo-Coffey, 2014;Pidano, Kimmelblatt, & Neace, 2011). As families often struggle to access mental health services beyond the primary care setting (Schoen, et al, 2006), the integration of physical and mental health services in PPC represents an important effort to address the needs of children and families.…”

Section: A Survey Of Pediatric Primary Care Psychologistsmentioning

confidence: 99%

“…Integration also reduces the time PCPs spend addressing mental health concerns, thereby increasing physician efficiency (Burt, et al, 2014;Cooper, 2006;Cummings, Odonahue, and Cummings 2009). …”

Section: Benefits Of Integrated Carementioning

confidence: 99%

Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists.

Hoffses

Riley

Menousek

et al. 2017

Clinical Practice in Pediatric Psychology

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The integration of mental health services in primary care settings has expanded rapidly in recent years with psychologists being at the forefront of efforts to promote healthy behaviors, reduce disease, and care for behavioral, emotional, and developmental needs to promote overall health and well-being for children and families (Asarnow, Kolko, Miranda, & Kazak, 2017;Stancin & Perrin, 2014). While there are many psychologists working in pediatric primary care (PPC), little is known about the specific activities that these psychologists engage in, the training they receive, or funding mechanisms that support their work. This study sought to address this gap in the literature through a survey of psychologists working in PPC. An anonymous online survey was disseminated to members of professional organizations and listservs who were identified as having interest in PPC. Psychologists (N ϭ 65) currently practicing in PPC completed the survey by reporting on clinical roles and practices, professional training, practice settings, and funding supports in PPC settings. Results indicate that psychologists assume a number of roles in PPC including providing individual and family therapy, conducting screenings for child mental health concerns, and providing consultation to medical colleagues. Many psychologists also provide supervision and offer educational opportunities for those in related fields, such as medicine and social work. Engagement in research activities was identified as a secondary activity. It was reported that a number of clinical activities were not billed for on a regular basis. Additional areas of research will be discussed along with implications for clinical services in PPC.

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Running Out of Time: Physician Management of Behavioral Health Concerns in Rural Pediatric Primary Care

Cited by 128 publications

References 22 publications

Seeing Is Believing: Using Skype to Improve Diabetes Outcomes in Youth

Seeing Is Believing: Using Skype to Improve Diabetes Outcomes in Youth

Demanda de hospitalización por causas psicosociales en un hospital pediátrico

Professional practices, training, and funding mechanisms: A survey of pediatric primary care psychologists.

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